CORONAVIRUS

Few COVID-19 cases at Area Ambulance despite risks

Service adopted strict protocols as pandemic began

Doug Wullweber, quality and compliance manager and paramedic at Area Ambulance in Cedar Rapids, demonstrates Tuesday how
Doug Wullweber, quality and compliance manager and paramedic at Area Ambulance in Cedar Rapids, demonstrates Tuesday how an ambulance is decontaminated using a .5 percent hydrogen peroxide solution. The company, which has been in Cedar Rapids for 50 years, increased its safety protocols at the beginning of the coronavirus pandemic. (Rebecca F. Miller/The Gazette)
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CEDAR RAPIDS — Despite their daily contact with the public in the Corridor, only a handful of Area Ambulance employees have tested positive for COVID-19 since the disease was confirmed in Iowa last March.

“We had to make a lot of adjustments when the pandemic hit,” said Keith Rippy, chief executive officer for Area Ambulance. “It’s affected almost every aspect of our operations and put a substantial increase in demand on our employees. We’ve never had to worry about (personal protective equipment) to this extent. We’re decontaminating ambulances daily, which we’ve never had to do before, and we’ve never had to worry about minimizing contact with the public like we have in the past year.”

A total of 14 Area Ambulance employees have tested positive for COVID-19 since the start of the pandemic, said Jackie Gillen, director of operations, and approximately 31 employees have been tested for the virus. A lot of those who tested positive did so during the early months of the pandemic.

The ambulance service currently employs about 70 full- and part-time emergency medical technicians and paramedics in Linn and Johnson counties, and an additional 10 in Buchanan County, some of whom are volunteer EMTs.

The ambulance service covers 250 square miles in Linn County, and well as portions of Johnson and Buchanan counties. In total, the service covers about 600 square miles, said Doug Wullweber, manager of quality and compliance.

Sixty-five of the 70 full- and part-time employees had received both doses of the COVID-19 vaccine as of early February.

When the novel coronavirus first appeared in Iowa, Area Ambulance implemented face mask protocols — ensuring its EMTs and paramedics were equipped with medical-grade N95 masks — and made sure that every rig was outfitted with adequate PPE, including gloves, face shields, gowns and masks.

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Additionally, temperatures were taken at the beginning of each shift and a two-week isolation period was required for anyone exhibiting symptoms of COVID-19.

But as the number of positive cases began to climb in communities and outbreaks erupted in long-term care facilities across the state, the ambulance service was forced to make further adjustments to minimize employee exposure.

“We get a lot of calls from long-term care facilities every day,” Gillen said. “So when we started getting notified of outbreaks in those facilities, we began asking the facility staff to bring the patients outside to us whenever possible and we would meet them at the front door. That way our people wouldn’t have to go inside.”

With winter in full effect, that procedure changed. The ambulance crews now are asking that the patient be brought to the front door, with the handoff occurring just inside.

With facilities that are experiencing significant outbreaks, the ambulance crews began leaving cots and asking the facility staff to load the patient onto that cot and bring him or her to the door where the ambulance crew would collect the patient — and leave behind an empty cot.

Patients are masked at first contact, regardless of their symptoms or where they are calling from, and whenever possible, patients are asked to meet the responding team outside or just inside the door. When it is necessary to go inside, one person from the two-unit team will go in first. The second will follow only if needed.

Depending on the call, Gillen said the ambulance crew might not be the only unit to show up — police and fire units might also respond.

“And in those cases, if we can, we’d try to save the police or the firefighters the exposure,” she said. “So if the police or fire department show up for some reason and we’ve determined we don’t need their assistance, we’ll wave them off. If we know we’re going to have to transport and we know that inevitably we’re going to have the exposure, it doesn’t make sense to have everybody else come in and risk exposure, too.”

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Last year, Area Ambulance responded to more than 25,000 calls in Linn and Johnson counties and about 1,000 calls in Buchanan County, about 17,000 of which resulted in patient transports.

Data from Area Ambulance shows that 1,467 patients were deemed by the dispatch screening process to possibly have COVID-19, and only 414 of those of those patients actually tested positive.

That said, it has been Area Ambulance’s protocol to treat every patient as if he or she were positive for the virus.

“I think that’s a big part of how we’ve managed to keep our infection rates low,” Gillen said.

The other part, she said, is likely the decontamination protocols. The service hired two people to clean the rigs and the equipment at the end of each shift.

“We didn’t want that all falling on the medics,” Gillen said. “They had so much on their minds already, and it seemed like a lot to pile on at the end of their already busy and stressful shifts.”

The decontamination process starts just outside the Area Ambulance garage, where crews wash the outside of rigs and sweep and clean the inside, Wullweber said.

Then the ambulance is brought inside and a UV light is placed in the back for 15 to 30 minutes, which Wullweber said “kills 99 percent of germs.”

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Then the decontamination specialist takes over, spraying every surface of the rig, and all the equipment, with a .5 percent hydrogen peroxide solution using an electrostatic sprayer.

After that, the rig is ready for its next crew.

“We think the process has been wildly successful,” Gillen said. “You know, I can’t outright say this is why our COVID numbers have stayed low, but I do believe it has played a big role in keeping our people safe, and that’s always been our biggest concern — that safety of our staff and our patients.”

Comments: (319) 398-8238; kat.russell@thegazette.com

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